WHO JILL HELPS

Orofacial Myofunctional Disorders (OMD) include the abnormal rest postures and functioning of the oral and facial muscles and soft tissue complex. OMD's can often result in an atypical swallow pattern that is often referred to as a "tongue thrust." This atypical swallow pattern involves the coordination and patterning related to mastication (chewing), bolus formation/collection and transport of the bolus posteriorly. During this atypical swallow the tongue will stabilize itself anteriorly or "between the teeth" during the transport phase. When the tongue positions itself forward or sideways against and/or between the teeth during the process, it can have an adverse affect on the position of the dentition, craniofacial development, the orofacial soft tissue complex and coordinated patterns of all the associated musculature. It is estimated this disorder is prevalent in 30% of the population.

The resting posture of the tongue, jaw, and lips are extremely important in the normal developmental growth patterns. Atypical patterns may result in improper resting position of the tongue resulting in "openbite" or other malocclusion and open mouth rest posture.

Contributing factors are often related to upper airway obstruction related to enlarged tonsils and/or adenoids, allergies, and sinus obstruction. Other contributors are related to non-nutritive sucking habits that include: thumb and digit sucking; extending use of pacifiers and sippy cups; bruxing and clenching of the dentition and facial muscles; and nail biting. Untreated OMD's can lead to the development of TMD (temporal mandibular disorder) and pain associated with it in adults.﻿

Tongue-tie is often another causative factor in the development of OMD's. Many specialists agree that a restricted lingual frenum can result in dental, speech,and skeletal changes (jaw and palate formation).

Because of the specialization of orofacial myology North Bay Speech works closely with a variety of healthcare professionals to address problems that may ensue. They include: pediatricians, otolaryngologists, allergists, dental specialists, maxial-facial surgeons, orthodontists, physical therapists, and chiropractors.

With OMD, the tongue moves forward in an exaggerated way at rest, during speech, and while swallowing. A tongue thrust is the most common orofacial myofunctional variation. The incorrect rest posture of the tongue contributes to improper orofacial development and malalignment of the teeth. The tongue may lie too far forward during rest or may protrude between the upper and lower teeth during speech and swallowing. Orofacial myology disorders may have a negative effect on the development of the dentition, particularly dental eruption patterns and/or alignment of the teeth and jaw. Speech patterns may become imprecise or misarticulated. Oral habit patterns (thumb sucking, finger sucking, prolonged pacifier, bottle, or sippy cup use) may have a negative influence on the structure of the hard palate and the normal functioning of the temporomandibular joint. Correcting the resting tongue or lip relationships can be instrumental in aiding the development of normal patterns of dental eruption and alignment. Research has found an 81% prevalence of orofacial myofunctional disorders in children exhibiting speech/articulation problems (Kelly, 1992, Maul, et. al, 1999).

Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words

Most children make some mistakes as they learn to say new words. A speech sound disorder occurs when mistakes continue past a certain age. Every sound has a different range of ages when the child should make the sound correctly. Speech sound disorders include problems with articulation (making sounds) and phonological processes (sound patterns).

Autism is a developmental disability. Children with autism, also known as autism spectrum disorder or ASD, may have difficulty with social skills and receptive/expressive language. They also have restricted and repetitive patterns of behavior, interests, or activities, such as flipping objects, echolalia, or excessive smelling or touching of objects. Autistic symptoms may be mild or severe.

An individual may say words clearly and use long, complex sentences with correct grammar, but still have a communication problem. Children with social pragmatic challenges may have difficulty communicating non-verbally, understanding/using humor, turn-taking, maintaining a topic, commenting and asking questions during conversations.